MCL – Medial Collateral Ligament Injury in the Knee

What is the MCL in the knee?

The MCL, also called the medial collateral ligament, does not get as much attention as the ACL, although it can be one of the most commonly injured knee ligaments. The MCL sits outside of the knee joint, on the inside of the knee. This ligament extends from the end of the femur (thigh bone) to the top of the tibia (shin bone). It is the MCL’s job to allow the knee to rotate, while keeping it stable and from collapsing inward. An injury to the MCL occurs when an extreme force is placed on the outer side of the knee, causing the ligament on the inside to stretch or tear. Athletes who participate in contact sports are the most likely individuals to suffer an MCL injury. Dr. Benedict Nwachukwu, orthopedic knee specialist, serving patients in Manhattan, New York City and the surrounding New York boroughs can successfully treat individuals with an MCL injury and return them to their regular sporting activities they love.

How does an MCL injury occur?

Athletes experience medial collateral ligament strains, sprains or injuries more often than any other group of individuals. Contact sports, such as football can cause an MCL injury. The injury occurs when the knee sustains a direct blow to the outside of the knee, forcing the inside ligament to stretch beyond its normal limit. Other causes of an MCL injury can be:

• Jumping incorrectly, causing the knee to twist
• Changing direction while running, causing the knee to twist
• An accident or blow to the outside of the knee

How are MCL tears classified?

MCL Tears are graded by the amount of tearing in the ligament:

• Grade 1 injury: The ligament is stretched, but not torn.
• Grade 2 injury: Partial tear of the ligament, causes instability in the knee
• Grade 3 injury: Complete tear of the ligament, causes a very unstable knee joint

What are the symptoms of an MCL Injury?

The symptoms of an MCL injury are very similar to other knee ligament injuries and should be evaluated by Dr. Nwachukwu. Patients in New York who experience MCL injuries often report:

• Popping sound at the time of injury
• Knee instability
• Locking or catching of the knee
• Limited range of motion
• Pain, tenderness and/or swelling on the inner part of the knee
• Pain at the time of injury

How is an MCL injury diagnosed?

The best diagnostic test for an injured MCL is an MRI scan. This scan allows Dr. Nwachukwu to visualize the soft tissues of the knee and to rule out any other ligament damage or involvement.  Dr. Nwachukwu will also conduct a thorough examination of the knee and perform a series of tests to determine knee stability, strength and pain symptoms.

How is an MCL injury treated?

Non-surgical treatment is often recommended by Dr. Nwachukwu for MCL injuries that are a grade 1 or 2.  Grade 3 MCL tears require surgery to return the ligament to its proper function.

Non-Surgical Treatment:

An MCL strain sprain or a partial tear that does not affect knee stability may be effectively treated with a combination of ice, rest, heat, physical therapy and bracing. Conservative treatment usually helps the ligament to heal and will allow for functional recovery and a return to normal activities in about 6 to 8 weeks.

Surgical Treatment:

Grade 3 MCL injuries that are a complete tear of the ligament require surgery to repair and reconstruct the ligament. Tears of this type often involve other ligaments and soft tissues that may also need to be repaired. Dr. Nwachukwu uses a minimally invasive surgical technique to assess and repair the damage. If, however the damage is severe or includes other soft tissues, an open surgical technique may be used to repair or reconstruct the ligament. This involves a slightly larger incision which will allow him to see the joint and make multiple repairs.

If the MCL can be repaired, Dr. Nwachukwu will suture the torn ligament back together, or he may suture it down to the bone to allow it to heal. Severe ligament damage that cannot be repaired can be replaced with an allograft (donor graft) or an autograft (from the patient). Patients in the New York area should seek out Dr. Nwachukwu, an orthopedic surgeon who specializes in MCL and other knee injuries, to obtain the best possible outcome.

How long does it take an MCL injury to heal?

Many MCL injuries heal without surgical intervention and the prognosis is generally good. For patients who require surgery, the recovery time is usually 5 to 6 weeks, if the MCL was the only injury and did not involve any other soft tissues. A hinged knee brace is often recommended for patients who return to sporting activities. The brace can help keep the knee stable and avoid further injuries.

For more information on an MCL injury or the treatment for medial collateral ligament pain, please contact the office of Benedict Nwachukwu, MD, orthopedic knee specialist serving Manhattan, New York City and the surrounding New York boroughs.